Individual
DEBORAH CORNISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
440 JEFFERSON ST NE, ZIA ES, ALBUQUERQUE, NM 87108-1235
(505) 255-7451
Mailing address
440 JEFFERSON ST NE, ZIA ES, ALBUQUERQUE, NM 87108-1235
(505) 255-7451
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
463
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L 6793
—
NM
Enumeration date
03/12/2007
Last updated
07/09/2007
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